The hallmark findings of Cushing syndrome include:

• A. Edema of the trunk, extremities, and face
• B. Wasting of the abdomen with thick, calloused skin
• C. Excess Adipose Tissue in the Trunk, Slender Extremities, and Moon Face
• D. High Levels of Potassium and Low Levels of Sodium, Weakness, and Wasting

Answer: (D)

Cushing syndrome is characterized by cortisol excess that changes fat distribution and muscle. The hallmark appearance is central (trunk) obesity with a round, moon-shaped face and relatively slender extremities, often with a dorsocervical fat pad (buffalo hump). Cortisol also promotes protein breakdown in muscles, especially in the proximal limbs, leading to thinning of the arms and legs. This combination—excess trunk fat, a moon face, and proximal muscle wasting—best captures the typical phenotype.

Electrolyte changes reflect cortisol’s mineralocorticoid effects: sodium is often retained and potassium is wasted, which can contribute to hypertension and hypokalemia. A pattern of high potassium with low sodium would be inconsistent with the usual cortisol-driven profile, so that option doesn’t fit with the hallmark features.